With overdoses skyrocketing, Congress must consider non-opioid alternatives to pain management
Drug overdose deaths in older adults have skyrocketed in recent years, jumping 147% over the last decade – the highest increase in any age group in the country. Among people 65 and older, men are twice as likely as women to suffer overdoses, and Black Americans are over 10% more likely than other minority groups. Given that seniors are more vulnerable to prescription drug overdoses, access to non-drug alternatives for pain management is especially important. Reducing opioid use starts with changing our approach to chronic pain management and increasing access to safe, effective, non-addictive treatment options.
Congress recognizes the need for new approaches to combat opioid misuse and drug addiction. In late May, the Senate passed a Resolution calling on Congress to advance bipartisan solutions to address substance use disorder needs of older adults, noting that our seniors are more susceptible to substance use disorder for several reasons. Last year, the House Energy and Commerce Committee held a hearing where members emphasized the need to better promote non-addictive treatments and asked the Food and Drug Administration (FDA) to prioritize non-addictive alternatives for pain management.
While this is a shift in the right direction, policymakers must also keep in mind the value of complementary and integrative healthcare (CIH) for seniors and chronic pain sufferers, to reduce opioid use and reliance. When CIH providers are utilized in pain management from the start, research shows that prescriptions for opioids plummet, which is a much smarter preventative strategy than managing addiction on the back end. The American College of Physicians strongly recommends starting with non-pharmacological treatment for both acute and chronic low back pain. Let’s follow the evidence and promote non-pharmacological pain management approaches as first-line treatments.
CIH providers, including chiropractic physicians, acupuncturists, and massage therapists, provide effective and safe treatments for pain. Yet, they are too often overlooked by Congress and a healthcare system that tends to default to pharmacological treatments as the first step in pain reduction. Patients are increasingly utilizing complementary and integrative therapies and expanding access to these care options giving seniors more choices and control over managing their health.
However, significant barriers – in addition to a lack of will by policymakers – prevent access to integrative care options and providers. The economics of the healthcare system limits access and fails to incentivize patient choice of high-value CIH services. Rather, they favor prescribing pharmacological approaches – including opioids – that do not reflect best practices for chronic pain management like those recommended by the American College of Physicians, the Joint Commission and the Centers for Disease Control and Prevention.
Increasing access and lowering financial barriers to non-pharmacological treatments is critical to ensuring high value care is incentivized and healthcare delivery reflects current best practices. Treating pain and related conditions with non-pharmacological options first has the potential to reduce drug dependencies, accidental overdoses and deaths, and other serious adverse effects, while preventing relapse of those struggling with addiction who may continue suffering from pain associated with acute injuries.
Legislative measures to combat opioid misuse and drug addiction should be accompanied by policies providing viable treatment alternatives for older adults. To do this, we must recognize CIH’s role in preventive care and ensure policies provide access to a full complement of healthcare professionals. Congress needs to prioritize access to CIH over more invasive and addictive treatments to alter the trajectory of our deadly opioid epidemic. By stressing the benefits of integrative healthcare to better support health creation over the lifespan, Congress can reform our country’s approach to chronic pain management.
Health Science education is training the next generation of healthcare professionals to prioritize effective, non-pharmacologic treatments for pain management, preparing the future workforce for evidence-based practice. It’s time for Congress to follow suit – Congress must advocate for and prioritize policies that include complementary and integrative healthcare.
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